INTRODUCTION: Intrauterine insemination (IUI) is commonly used to treat unexplained infertility. Hormonal markers, especially estradiol (E2) and progesterone (P), are crucial in predicting endometrial receptivity and pregnancy outcomes. This study investigates the predictive value of E2 and P levels measured on the day of human chorionic gonadotropin (hCG) administration and IUI.
METHODS: A retrospective review was conducted on 81 women aged 18–38 who underwent IUI for unexplained infertility between 2018 and 2020. Serum E2 and P levels were assessed on hCG and IUI days. Pregnancy outcomes were compared using t-tests and chi-square tests (p < 0.05) via SPSS 25.0.
RESULTS: Out of 81 participants, 11 achieved pregnancy (13.5%). Pregnant women had significantly higher E2 levels on hCG (472.3 ± 291.3 vs. 398.6 ± 277.2 pg/mL, p = 0.018) and IUI days (425.3 ± 269.1 vs. 371.2 ± 275.8 pg/mL, p = 0.033). P levels were also higher in this group on both days (hCG: 1.43 ± 1.62 vs. 0.74 ± 1.29 ng/mL, p = 0.001; IUI: 2.48 ± 1.92 vs. 2.31 ± 2.12 ng/mL, p = 0.024). Lower IUI-to-hCG hormone ratios were noted in the pregnant group (E2: 0.90 vs. 0.93, p = 0.045; P: 1.7 vs. 3.1, p = 0.001).
DISCUSSION AND CONCLUSION: Elevated E2 and P levels on hCG and IUI days are associated with improved pregnancy outcomes. Hormonal monitoring may enhance IUI success and guide personalized infertility treatments.

INTRODUCTION: Advanced maternal age (AMA) pregnancies are associated with increased maternal and perinatal risks; however, the relative contribution of maternal age itself versus accompanying maternal characteristics remains debated. This study aimed to evaluate maternal characteristics and perinatal outcomes in women aged ≥35 years compared with those aged 20–35 years.
METHODS: This retrospective comparative cohort study included singleton pregnancies delivered between January 2022 and July 2025 at a tertiary referral center. Women aged ≥35 years constituted the AMA group, while women aged 20–35 years served as controls. Maternal characteristics, obstetric complications, mode of delivery, and perinatal outcomes were compared between groups. Neonatal intensive care unit (NICU) admission was defined as the primary outcome.
RESULTS: A total of 599 women were included (300 AMA, 299 controls). Overweight/obesity, gestational diabetes mellitus, chronic hypertension, and cesarean delivery were significantly more frequent in the AMA group (all p < 0.01). NICU admission was higher among infants born to women aged ≥35 years compared with controls (25.0% vs. 10.4%, p < 0.001). Other key neonatal outcomes, including birth weight, Apgar scores, fetal growth restriction, and preterm birth, did not differ significantly between groups. Multivariable logistic regression analysis demonstrated that increased body mass index, gestational diabetes mellitus, and cesarean delivery were independently associated with the advanced maternal age group.
DISCUSSION AND CONCLUSION: Advanced maternal age was associated with a higher burden of maternal comorbidities and increased cesarean delivery rates, whereas most neonatal outcomes were comparable between age groups. These findings suggest that adverse perinatal outcomes in AMA pregnancies are largely driven by coexisting maternal characteristics rather than maternal age alone when appropriate care is provided.

INTRODUCTION: To evaluate the impact of levetiracetam monotherapy on obstetric and neonatal outcomes in pregnant women with epilepsy.
METHODS: The present retrospective cohort study included pregnant women with epilepsy followed at our center from the first trimester onward. Patients with seizures during pregnancy, polytherapy use, and multiple gestations were excluded. Patients were divided into a non-medicated group and a levetiracetam monotherapy group. Demographic, obstetric, delivery, and neonatal outcomes were compared.
RESULTS: A total of 74 patients were included in the study; 22 (29.7%) were assigned to the non-medicated group, and 52 (70.3%) were included in the levetiracetam group. No statistically significant differences were observed between the groups in maternal age, obstetric history, duration of epilepsy, gestational age at delivery, and APGAR scores. Neonatal birth weight was significantly lower (p = 0.042) and neonatal intensive care unit admission rates were significantly higher in the levetiracetam group (p = 0.047).
DISCUSSION AND CONCLUSION: Levetiracetam monotherapy was associated with lower neonatal birth weight and higher NICU admission rates, without significant differences in other major perinatal outcomes. These findings suggest that levetiracetam may represent a relatively safe treatment option during pregnancy with appropriate patient selection and close monitoring; however, larger prospective studies are needed.

INTRODUCTION: To evaluate the imaging spectrum of biliary complications in living liver donors using magnetic resonance cholangiopancreatography (MRCP) and to investigate the relationship between postoperative biliary complications and biliary anatomy.
METHODS: In this retrospective single-center study, adult living liver donors who underwent transplantation between January 2017 and January 2025 were reviewed. Donors were followed clinically and with imaging according to institutional protocols, and MRCP was performed when biliary complications were suspected. Preoperative MRCP examinations were analyzed to classify biliary anatomy and obtain morphometric measurements. Imaging characteristics were compared between donors with and without biliary complications.
RESULTS: A total of 181 donors were included, and radiologic biliary complications were identified in 16 donors (8.8%). Early bile leakage and biloma formation constituted the predominant imaging phenotype (68.8%), whereas biliary strictures were less frequent, presenting as common hepatic duct narrowing within the first month in three donors and as later strictures detected at 5.5 and 8 months in two donors. Variant biliary anatomy appeared numerically more frequent among donors with complications but was not significantly associated with complication development (p=0.282). Hepatocyte-specific contrast–enhanced MRI confirmed active bile leakage in selected cases. Three donors demonstrated biochemical cholestasis despite normal MRCP findings, highlighting the role of imaging in avoiding unnecessary invasive procedures.
DISCUSSION AND CONCLUSION: MRCP provides a comprehensive, noninvasive framework for detecting biliary complications in living liver donors. Early imaging should focus on bile leak, while later surveillance is important for identifying biliary strictures, supporting a time-oriented radiologic approach to donor follow-up.

INTRODUCTION: Although early diagnosis and management of GDM aims to reduce adverse outcomes for the mother and newborn, the prognostic value of the number of positive values in the 75 g OGTT remains unclear. This study investigates whether single, double, or triple positive values in the 75 g OGTT are associated with maternal and neonatal outcomes in women diagnosed with GDM.
METHODS: This retrospective, single-center study included 120 pregnant women diagnosed with GDM according to IADPSG criteria based on a 75 g OGTT after an 8-hour fast between April 2024 and December 2025.Groups were defined by the number of abnormal values in the 75g OGTT (fasting ≥92 mg/dL, 1-hour ≥180 mg/dL, 2-hour ≥153 mg/dL): single (one abnormal), double (two), or triple (all three). The data collected included age, number of pregnancies, number of births, gestational age at delivery, HbA1c, treatment method, birth weight, Apgar scores, NICU admission, neonatal hypoglycemia, hyperbilirubinemia, and macrosomia.
RESULTS: HbA1c was higher in Group 3 (mean difference vs. Group 1: 1.82 ± 0.32, p<0.001); cesarean rates were 95% in Group 1 vs. 60% in Group 3 (absolute difference: 35%, p=0.024). Macrosomia, Apgar scores at 1 and 5 minutes, admission to the NICU, neonatal hypoglycemia, and hyperbilirubinemia, among other neonatal outcomes, did not differ significantly between groups.
DISCUSSION AND CONCLUSION: Among pregnant women diagnosed with GDM using a 75 g OGTT, increased positive values were associated with higher maternal HbA1c and increased likelihood of cesarean delivery, but this did not lead to consistent differences in neonatal morbidity.